cardiac concepts med surg success

The nurse is caring for a client diagnosed with coronary artery disease. Which should the nurse teach the client prior to discharge? 1. Carry your nitroglycerin tablets in a brown bottle. 2. Swallow a nitroglycerin tablet at the first sign of angina. 3. If one nitroglycerin tablet does not work in 10 minutes, take another. 4. Nitroglycerin tablets have a fruity odor if they are potent.

1. Carry your nitroglycerin tablets in a brown bottle. Nitroglycerin tablets are dispensed in small brown bottles to preserve their potency. The client should not change the tablets to another container.

The nurse is functioning in the role of medication nurse during a code. Which should the nurse implement when administering amiodarone for ventricular tachycardia? 1. Mix the medication in 100 mL of fluid and administer rapidly. 2. Push the amiodarone directly into the nearest IV port and raise the arm. 3. Question the physician's order because it is not ACLS recommended. 4. Administer via an IV pump based on mg/kg/min.

1. Mix the medication in 100 mL of fluid and administer rapidly. Amiodarone is administered during a code rapidly after being mixed in 100 mL of fluid.

The nurse identifies the concept of altered tissue perfusion related to a client admitted with atrial fibrillation. Which interventions should the nurse implement? Select all. 1. Monitor the client's blood pressure and apical rate every four hours. 2. Place the client on intake and output every shift. 3. Require the client to sleep with the head of the bed elevated. 4. Teach the patient to perform Buerger Allen exercises daily. 5. Determine if the client is on an antiplatelet or anticoagulant medication. 6. Assess the client's neurological status every shift and prn.

1. Monitor the client's blood pressure and apical rate every four hours. 2. Place the client on intake and output every shift. 5. Determine if the client is on an antiplatelet or anticoagulant medication. 6. Assess the client's neurological status every shift and prn.

The client diagnosed with an ST elevation myocardial infarction (STEMI) has developed 2 + edema bilaterally of the lower extremities and has crackles in all lung fields. Which should the nurse implement first? 1. Notify the health care provider. 2. Assess what the client ate at the last meal. 3. Request a STAT 12 lead electrocardiogram. 4. Administer furosemide IVP.

1. Notify the health care provider. "Has developed" indicates a new issue; the nurse should notify the HCP of the assessment findings, which indicate that the client has developed heart failure.

The nurse is administering morning medications to clients on a telemetry unit. Which medication would the nurse question? 1. Furosemide IVP to a client with a potassium level of 3.6 mEq/L. 2. Digoxin orally to a client diagnosed with rapid atrial fibrillation. 3. Enalapril orally to a client whose BP is 86/64 and apical pulse is 65. 4. Morphine IVP to a client complaining of chest pain and who is diaphoretic.

3. Enalapril orally to a client whose BP is 86/64 and apical pulse is 65. Enalapril, an ACE inhibitor, will lower the blood pressure even more. The nurse should hold the medication and notify the HCP that the medication is being held.

The nurse is working with a group of new graduates on a medical-surgical unit. Which should the nurse explain about completing first morning rounds on clients? 1. Perform a "down and dirty" assessment on each client soon after receiving report. 2. Determine which client should have a bath and inform the unlicensed assistive personnel. 3. Give all the clients a wet wash to wash the face and a toothbrush and toothpaste. 4. Pick up any paper on the floor and get the room ready for morning physician rounds..

1. Perform a "down and dirty" assessment on each client soon after receiving report. "Down and dirty" rounds include assessing each client for the main focus of the client's admission or any new issue that is reported from the shfit report and assessing all lines and tubes going into or coming out fo the client. Once this is done the nurse knows then that the client is stable and a full head-to-toe assessment can be done at a later time.

The home health nurse is assigned a client diagnosed with heart failure. Which should the nurse implement? Select all that apply. 1. Request a dietary consult for a sodium-restricted diet. 2. Instruct the client to elevate the feet during the day. 3. Teach the client to weigh every morning wearing the same type of clothing. 4. Assess for edema in dependent areas of the body. 5. Encourage the client to drink at least 3,000 mL of fluid per day. 6. Have the client repeat back instructions to the nurse.

1. Request a dietary consult for a sodium-restricted diet. 2. Instruct the client to elevate the feet during the day. 3. Teach the client to weigh every morning wearing the same type of clothing. 4. Assess for edema in dependent areas of the body 6. Have the client repeat back instructions to the nurse.

The nurse has received shift report. Which client should the nurse assess first? 1. The client diagnosed with coronary artery disease complaining of severe indigestion. 2. The client diagnosed with congestive heart failure who has 3+ pitting edema. 3. The client diagnosed with atrial fibrillation whos apical rate is 110 and irregular. 4. The client diagnosed with sinus bradycardia who is complaining of being constipated.

1. The client diagnosed with coronary artery disease complaining of severe indigestion. A complaint and indigestion could be cardiac chest pain. The nurse should assess this client because of the diagnosis of CAD and the word "severe" in the option.

The nurse identifies the concept of tissue perfusion as a client problem. Which is an antecedent of tissue perfusion? 1. The client has a history of coronary artert disease. 2. The client has a history of diabetes insipidus 3. The client has a history of chronic obstructive pulmonary diease. 4. The client has a history of multiple fractures from a motor-vehicle accident.

1. The client has a history of coronary artert disease. CAD narrows the arteries of the heart, causing the tissues not to be perfused, especially when an embolus or a thrombus occurs.

The client diagnosed with a myocardial infarction is being discharged. Which discharge instruction(s) whould the nurse teach the client? 1. Call the health care provider if any chest pain happens. 2. Discuss when the client can resume sexual activity. 3. Explain the pharmacology of nitroglycerin tablets. 4. Encourage the client to sleep with the head of the bed elevated.

2. Discuss when the client can resume sexual activity. The nurse should make sure the client is aware of when sexual activity can be safely resumed.

The 45-year-old male client diagnosed with essential hypertension has decided not to take his medications. The client's BP is 178/94, indicating a perfusion issue. Which question should the nurse ask the client first? 1. Do you have the money to buy your medication? 2. Does the medication give you unwanted side effects? 3. Did you quit taking the medications because you don't feel bad? 4. Can you tell me why you stopped taking the medication?

2. Does the medication give you unwanted side effects? This is a mild way of introducing the subject of side effects to a client not wishing to admit the medication causes unwated effects. It opens the door to more probing assessment questions. The nurse should bring up the subject in order to allow the client to be forthcoming with the issues of why he is not taking his medication.

The nurse identifies the concept of perfusion for a client diagnosed with congestive heart failure. Which assessment data support this concept? 1. The client has a large abdomen and a positive tympanic wave. 2. The client has paroxysmal nocturnal dyspnea. 3. The cliet has 2 + glucose in the urine. 4. The client has a comorbid condition of myocardial infarction.

2. The client has paroxysmal nocturnal dyspnea. Dyspnea occuring at night when the client is recumbent position indicates taht the cardiac muscle is not able to compensate for extra fluid returning to the heart during sleep.

The nurse is administering morning medications. Which medication should be administered first? 1. The cardiac glycoside medication, digoxin, to a client diagnosed with heart failure and who has 2+ edema of the feet. 2. The sliding scale insulin to a client with a fasting blood glucose of 345 mg/dL who is demanding breakfast. 3. The loop diuretic, furosemide, to a client with a 24-hour intake of 986 mL and an output of 1,400 mL. 4. The ARB medication to a client whose blood pressure was reported by the unlicensed assistive personell as 142/76.

2. The sliding scale insulin to a client with a fasting blood glucose of 345 mg/dL who is demanding breakfast. The client intends on eating breakfast and this is a scheduled medication for before meals.

The nurse is caring for a client who suddenly complains of crushing substernal cest pain while ambulating in the hall. Which nursing action should the nurse implement first? 1. Call a code blue 2. Assess the telemetry reading 3. Take the client's apical pulse 4. Have the client sit down.

4. Have the client sit down. The client began to have a problem during physical exertion. Stopping the exertion should be the first action taken by the nurse.

The nurse is admitting a client diagnosed with coronary artery disease (CAD) and angina. Which concept is priority? 1. Sleep, rest, activity 2. Comfort 3. Oxygenation 4. Perfusion

4. Perfusion The cardiac muscle is not perfused when there is an narrowing of the arteries caused by CAD or when and embolus or thrombus occludes the artery. Adequate perfusion will supply oxygen to the cardiac muscle, allow for increased activity, and decrease pain.

The nurse enters the client's room and notes and unconscious client with an absence of respirations and no pulse or blood pressure. The concept of perfusion is identified by the nurse. Which should the nurse implement first? 1. Notify the health care provider. 2. Call a rapid response team. 3. Determine a telemetry monitor reading. 4. Push the code blue button.

4. Push the code blue button. The first action is to immediatley notify the code team and initiate CPR